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  • 1
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    Validation of the OAKS prognostic model for acute kidney injury after gastrointestinal surgery
    Oxford University Press (OUP) ; 2022
    In:  BJS Open Vol. 6, No. 1 ( 2022-01-06)
    Details
    In: BJS Open, Oxford University Press (OUP), Vol. 6, No. 1 ( 2022-01-06)
    Abstract: Postoperative acute kidney injury (AKI) is a common complication of major gastrointestinal surgery with an impact on short- and long-term survival. No validated system for risk stratification exists for this patient group. This study aimed to validate externally a prognostic model for AKI after major gastrointestinal surgery in two multicentre cohort studies. Methods The Outcomes After Kidney injury in Surgery (OAKS) prognostic model was developed to predict risk of AKI in the 7 days after surgery using six routine datapoints (age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker). Validation was performed within two independent cohorts: a prospective multicentre, international study (‘IMAGINE’) of patients undergoing elective colorectal surgery (2018); and a retrospective regional cohort study (‘Tayside’) in major abdominal surgery (2011–2015). Multivariable logistic regression was used to predict risk of AKI, with multiple imputation used to account for data missing at random. Prognostic accuracy was assessed for patients at high risk (greater than 20 per cent) of postoperative AKI. Results In the validation cohorts, 12.9 per cent of patients (661 of 5106) in IMAGINE and 14.7 per cent (106 of 719 patients) in Tayside developed 7-day postoperative AKI. Using the OAKS model, 558 patients (9.6 per cent) were classified as high risk. Less than 10 per cent of patients classified as low-risk developed AKI in either cohort (negative predictive value greater than 0.9). Upon external validation, the OAKS model retained an area under the receiver operating characteristic (AUC) curve of range 0.655–0.681 (Tayside 95 per cent c.i. 0.596 to 0.714; IMAGINE 95 per cent c.i. 0.659 to 0.703), sensitivity values range 0.323–0.352 (IMAGINE 95 per cent c.i. 0.281 to 0.368; Tayside 95 per cent c.i. 0.253 to 0.461), and specificity range 0.881–0.890 (Tayside 95 per cent c.i. 0.853 to 0.905; IMAGINE 95 per cent c.i. 0.881 to 0.899). Conclusion The OAKS prognostic model can identify patients who are not at high risk of postoperative AKI after gastrointestinal surgery with high specificity. Presented to Association of Surgeons in Training (ASiT) International Conference 2018 (Edinburgh, UK), European Society of Coloproctology (ESCP) International Conference 2018 (Nice, France), SARS (Society of Academic and Research Surgery) 2020 (Virtual, UK).
    Type of Medium: Online Resource
    ISSN: 2474-9842
    URL: Article
    DOI: 10.1093/bjsopen/zrab150
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2902033-5
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  • 2
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    Impact of postoperative acute kidney injury in patients undergoing major gastrointestinal surgery on 1-year survival and renal outcomes: a national multicentre cohort study
    Oxford University Press (OUP) ; 2021
    In:  BJS Open Vol. 5, No. 6 ( 2021-11-09)
    Details
    In: BJS Open, Oxford University Press (OUP), Vol. 5, No. 6 ( 2021-11-09)
    Abstract: The intermediate-term impact of acute kidney injury (AKI) in patients after major gastrointestinal and liver surgery has not been well characterized. This study aimed to evaluate the 1-year mortality rate and renal outcomes associated with postoperative AKI in a national prospective cohort. Methods This prospective multicentre, observational cohort with 1-year postoperative follow-up included adults undergoing major gastrointestinal and liver surgery across the UK and Ireland between 23 September and 18 November 2015. AKI was defined according to Kidney Disease Improving Global Outcomes (KDIGO) criteria. The primary outcome was death at 1-year after surgery, and the secondary outcome was Major Adverse Kidney Events (MAKE-365). Cox proportionate and multilevel logistic regression were used to account for case mix. Results Of 5745 patients across 173 centres, 1-year follow-up data was completed for 3504 patients (62.2 per cent, 126 centres), with attrition largely explained by centre non-participation (63.1 per cent). Some 13.6 per cent (475 of 3504) patients developed AKI by 7 days after surgery (stage 1: 9.2 per cent; stage 2/3: 4.3 per cent). At 1 year, 10.8 per cent (378 patients) experienced a MAKE-365 endpoint (303 patients had died, 61 had renal replacement therapy and 78 had renal dysfunction). Patients who experienced AKI by 7 days after surgery had a higher hazard of death at 1 year for KDIGO stage 1 (hazard ratio 1.50 (95 per cent c.i. 1.08 to 2.08), P = 0.016) and KDIGO stage 2/3 (hazard ratio 2.96 (95 per cent c.i. 2.02 to 4.33), P & lt; 0.001). Both KDIGO stage 1 (odds ratio 2.09 (95 per cent c.i. 1.50 to 2.92), P & lt; 0.001) and stage 2/3 (odds ratio 9.26 (95 per cent c.i. 6.31 to 13.59), P & lt; 0.001) AKI were independently associated with MAKE-365. Conclusion AKI events within 7 days after gastrointestinal or liver surgery are associated with significantly worse survival and renal outcomes at 1 year.
    Type of Medium: Online Resource
    ISSN: 2474-9842
    URL: Article
    DOI: 10.1093/bjsopen/zrab134
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2902033-5
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  • 3
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    Postexercise Activation of Muscle Metaboreceptors Modulates Whole-Body Evaporative Heat Loss : 1586 Board #261 June 1 9 00 AM - 10 30 AM
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Medicine & Science in Sports & Exercise Vol. 49, No. 5S ( 2017-05), p. 449-
    Details
    In: Medicine & Science in Sports & Exercise, Ovid Technologies (Wolters Kluwer Health), Vol. 49, No. 5S ( 2017-05), p. 449-
    Type of Medium: Online Resource
    ISSN: 0195-9131
    URL: Article
    DOI: 10.1249/01.mss.0000518116.25047.ad
    RVK:
    ZX 1000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2031167-9
    SSG: 31
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  • 4
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    Heat Loss Is Impaired in Older Men on the Day after Prolonged Work in the Heat
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Medicine & Science in Sports & Exercise Vol. 50, No. 9 ( 2018-9), p. 1859-1867
    Details
    In: Medicine & Science in Sports & Exercise, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. 9 ( 2018-9), p. 1859-1867
    Abstract: Prolonged work in the heat may exacerbate the rise in core temperature on the next work day, especially in older workers who display impairments in whole-body heat loss that increase body heat storage and core temperature relative to young adults during heat stress. We therefore evaluated whether whole-body heat loss in older adults was impaired on the day after prolonged work in the heat. Methods Whole-body heat exchange and heat storage were assessed in nine older (53–64 yr) men during three 30-min bouts of semirecumbent cycling at fixed rates of metabolic heat production (150 [Ex1], 200 [Ex2] , 250 W·m −2 [Ex3]), each separated by 15-min recovery, in hot-dry conditions (40°C, 20% relative humidity), immediately before (day 1), and on the day after (day 2) a prolonged, work simulation (~7.5 h) involving moderate-intensity intermittent exercise in hot-dry conditions (38°C, 34% relative humidity). Total heat loss (evaporative ± dry heat exchange) and metabolic heat production were measured using direct and indirect calorimetry, respectively. Body heat storage was quantified as the temporal summation of heat production and loss. Results Total heat loss (mean ± SD) during Ex1 did not differ between days 1 and 2 (151 ± 15 and 147 ± 14 W·m −2 , respectively; P = 0.27), but was attenuated on day 2 during Ex2 (181 ± 15 W·m −2 ) and Ex3 (218 ± 16 W·m −2 ) relative to day 1 (192 ± 14 and 230 ± 19 W·m −2 , respectively; both P 〈 0.01). Consequently, body heat storage throughout the protocol on day 2 (276 ± 114 kJ) was 31% greater than on day 1 (191 ± 87 kJ; P 〈 0.01). Conclusions Prolonged work in the heat causes next-day impairments in whole-body heat loss, which exacerbate heat storage and may elevate the risk of heat injury on the following day in older workers.
    Type of Medium: Online Resource
    ISSN: 1530-0315 , 0195-9131
    URL: Article
    DOI: 10.1249/MSS.0000000000001643
    RVK:
    ZX 1000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2031167-9
    SSG: 31
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  • 5
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    Does a Prolonged Work Day in the Heat Impair Heat Loss on the Next Day in Young Men?
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Medicine & Science in Sports & Exercise Vol. 50, No. 2 ( 2018-02), p. 318-326
    Details
    In: Medicine & Science in Sports & Exercise, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. 2 ( 2018-02), p. 318-326
    Type of Medium: Online Resource
    ISSN: 0195-9131
    URL: Article
    DOI: 10.1249/MSS.0000000000001444
    RVK:
    ZX 1000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2031167-9
    SSG: 31
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  • 6
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    Heat Exchange in Young and Older Men during Constant- and Variable-Intensity Work
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Medicine & Science in Sports & Exercise Vol. 52, No. 12 ( 2020-12), p. 2628-2636
    Details
    In: Medicine & Science in Sports & Exercise, Ovid Technologies (Wolters Kluwer Health), Vol. 52, No. 12 ( 2020-12), p. 2628-2636
    Abstract: Current occupational heat stress guidelines rely on time-weighted averaging to quantify the metabolic demands of variable-intensity work. However, variable-intensity work may be associated with impairments in whole-body total heat loss (dry + evaporative heat loss), especially in older workers, which exacerbate heat strain relative to constant-intensity work eliciting the same time-weighted average metabolic rate. We, therefore, used direct calorimetry to evaluate whether variable-intensity work would cause decrements in the average rate of whole-body total heat loss that augment body heat storage and core temperature compared with constant-intensity work in young and older men. Methods Eight young (19–31 yr) and eight older (54–65 yr) men completed four trials involving 90 min of work (cycling) eliciting an average metabolic heat production of ~200 W·m −2 in dry-heat (40°C, 20% relative humidity). One trial involved constant-intensity work (CON), whereas the others involved 10-min cycles of variable-intensity work: 5-min low-intensity and 5-min high-intensity (VAR 5:5), 6-min low-intensity and 4-min very high-intensity (VAR 6:4), and 7-min low- and 3-min very, very high-intensity (VAR 7:3). Metabolic heat production, total heat loss, body heat storage (heat production minus total heat loss), and core (rectal) temperature were measured throughout. Results When averaged over each 90-min work period, metabolic heat production, total heat loss, and heat storage were similar between groups and conditions (all P ≥ 0.152). Peak core temperature (average of final 10 min) was also similar between groups and conditions (both P ≥ 0.111). CONCLUSIONS Whole-body total heat loss, heat storage, and core temperature were not significantly influenced by the partitioning of work intensity in young or older men, indicating that time-weighted averaging appears to be appropriate for quantifying the metabolic demands of variable-intensity work to assess occupational heat stress.
    Type of Medium: Online Resource
    ISSN: 1530-0315 , 0195-9131
    URL: Article
    DOI: 10.1249/MSS.0000000000002410
    RVK:
    ZX 1000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2031167-9
    SSG: 31
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  • 7
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    Exercise Heat Stress in Patients With and Without Type 2 Diabetes
    American Medical Association (AMA) ; 2019
    In:  JAMA Vol. 322, No. 14 ( 2019-10-08), p. 1409-
    Details
    In: JAMA, American Medical Association (AMA), Vol. 322, No. 14 ( 2019-10-08), p. 1409-
    Type of Medium: Online Resource
    ISSN: 0098-7484
    URL: Article
    DOI: 10.1001/jama.2019.10943
    RVK:
    XA 10000
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2019
    detail.hit.zdb_id: 2958-0
    detail.hit.zdb_id: 2018410-4
    SSG: 5,21
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  • 8
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    Sleep Subdomain of the Sinonasal Outcome Test as a Potential Screening Tool for Sleep Apnea in Chronic Rhinosinusitis
    Wiley ; 2023
    In:  The Laryngoscope Vol. 133, No. 8 ( 2023-08), p. 2029-2034
    Details
    In: The Laryngoscope, Wiley, Vol. 133, No. 8 ( 2023-08), p. 2029-2034
    Abstract: Approximately 20% of patients with chronic rhinosinusitis (CRS) have comorbid obstructive sleep apnea (OSA). Patients with undiagnosed OSA are at high risk for perioperative complications. The Sinonasal Outcomes Test (SNOT‐22) Questionnaire is commonly administered to CRS patients, whereas OSA screening tools are less routinely employed. This study compared SNOT‐22 sleep subdomain (Sleep‐SNOT) scores among non‐OSA CRS versus OSA‐CRS patients undergoing ESS, and assessed sensitivity, specificity, and diagnostic accuracy of the Sleep‐SNOT for OSA screening. Methods Retrospective review of patients that underwent endoscopic sinus surgery (ESS) for CRS from 2012 to 2021. Patients either carried a reported OSA diagnosis and completed the SNOT‐22, or had undocumented OSA status and completed both STOP‐BANG and SNOT‐22. Demographics, questionnaire scores, and OSA status were collected. A receiver operating characteristic (ROC) curve assessed cutoff scores, sensitivity, and specificity of the Sleep‐SNOT for OSA screening. Results Of 600 patients reviewed, 109 were included. 41% had comorbid OSA. OSA patients had a higher BMI (32.1 ± 7.7 vs. 28.35 ± 6.7 kg/m 2 ; p  = 0.02), Sleep‐SNOT (21.96 ± 12.1 vs. 16.8 ± 11.2; p  = 0.021) and STOP‐BANG (3.1 ± 1.44 vs. 2.06 ± 1.27; p  = 0.038) scores. A Sleep‐SNOT score of 17.5 had a sensitivity of 68.9%, specificity of 55.7%, and diagnostic accuracy of 63% for OSA detection ( p  = 0.022). Conclusions Sleep‐SNOT scores are greater for CRS‐OSA patients. The Sleep‐SNOT ROC curve demonstrates a high sensitivity, specificity, and accuracy for OSA screening in CRS patients. A Sleep‐SNOT score of ≥17.5 should prompt further OSA evaluation. The Sleep‐SNOT may be considered as a surrogate OSA screening tool when other validated tools are not employed. Level of Evidence Retrospective chart review, Level 3 Laryngoscope , 133:2029–2034, 2023
    Type of Medium: Online Resource
    ISSN: 0023-852X , 1531-4995
    URL: Issue
    URL: Article
    DOI: 10.1002/lary.v133.8
    DOI: 10.1002/lary.30730
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2026089-1
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  • 9
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    The potential of nano-structured silicon oxide type coatings deposited by PACVD for control of aquatic biofouling
    Informa UK Limited ; 2009
    In:  Biofouling Vol. 25, No. 1 ( 2009-01), p. 55-67
    Details
    In: Biofouling, Informa UK Limited, Vol. 25, No. 1 ( 2009-01), p. 55-67
    Type of Medium: Online Resource
    ISSN: 0892-7014 , 1029-2454
    URL: Article
    DOI: 10.1080/08927010802444275
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2009
    detail.hit.zdb_id: 2028369-6
    SSG: 12
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  • 10
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    Whole‐body heat exchange in black‐African and Caucasian men during exercise eliciting matched heat‐loss requirements in dry heat
    Wiley ; 2020
    In:  Experimental Physiology Vol. 105, No. 1 ( 2020-01), p. 7-12
    Details
    In: Experimental Physiology, Wiley, Vol. 105, No. 1 ( 2020-01), p. 7-12
    Abstract: What is the central question of this study? Black‐African descendants are thought, by some, to possess genotypic adaptations conducive to survival in hot climates. We therefore assessed whether Canadian residents of black‐African descent display enhanced whole‐body total heat loss (evaporative plus dry heat exchange) in comparison to Caucasian Canadians during exercise eliciting matched heat‐loss requirements in dry heat. What is the main finding and its importance? Neither whole‐body total heat loss nor body heat storage differed significantly between groups, irrespective of the exercise intensity. Our findings indicate that genotypic adaptations associated with ethnicity do not appreciably modify whole‐body heat exchange during exercise–heat stress. Abstract Ethnicity has long been thought to modulate thermoregulatory function; however, an evaluation of whole‐body heat exchange in men of black‐African descent and Caucasian men (white‐European descendants), born and raised in the same climate, during exercise eliciting matched heat‐loss requirements remained unavailable. We therefore used direct calorimetry to assess whole‐body total heat loss (evaporative plus dry heat exchange) in young (18–30 years of age), second‐generation (or higher) black‐African ( n  = 11) and Caucasian ( n  = 11) men. Participants performed three 30 min bouts of semi‐recumbent cycling at fixed metabolic heat productions (and therefore matched heat‐loss requirements between groups) of 200 (light), 250 (moderate) and 300 W m −2 (vigorous), each followed by 15 min recovery, in dry heat (40°C, ∼13% relative humidity). Across all exercise bouts, dry ( P  = 0.435) and evaporative ( P  = 0.600) heat exchange did not differ significantly between groups. As such, total heat loss during light, moderate and vigorous exercise was similar between groups ( P  = 0.777), averaging [mean (SD)] 177 (10), 217 (13) and 244 (20) W m −2 in black‐African men and 172 (13), 212 (17) and 244 (17) W m −2 in Caucasian men. Accordingly, body heat storage across all exercise bouts (summation of metabolic heat production and total heat loss) was also similar between the black‐African [568 (142) kJ] and Caucasian groups [623 (124) kJ; P  = 0.356]. We demonstrated that, when assessed in young, second‐generation (or higher) black‐African and Caucasian men during exercise eliciting matched heat‐loss requirements in dry heat, ethnicity did not significantly modulate whole‐body dry and evaporative heat exchange or the resulting changes in total heat loss and body heat storage.
    Type of Medium: Online Resource
    ISSN: 0958-0670 , 1469-445X
    URL: Issue
    URL: Article
    DOI: 10.1113/eph.v105.1
    DOI: 10.1113/EP088091
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 1493802-9
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